RENAL HEALTH OUTCOMES FOR MĀORI FOLLOWING CRITICAL ILLNESS IN A TERTIARY INTENSIVE CARE UNIT IN AOTEAROA NEW ZEALAND

M MOHD SLIM 1,  H LALA , N BARNES ,  R MARTYNOGA

1Waikato Intensive Care Unit, Hamilton, New Zealand

Aim: Describe ethnic inequity in the RRT-requiring population in our ICU

Background: Māori in New Zealand (NZ) are disproportionately affected by chronic kidney disease (CKD), and experience lower life expectancy on community dialysis compared to non-Māori. We previously identified higher renal replacement therapy (RRT) requirement for Māori in our intensive care unit (ICU), which is the tertiary referral centre for NZ’s Te Manawa Taki region.

Methods: Retrospective audit of the Australia and NZ Intensive Care Society database for all adult admissions to our general ICU from Te Manawa Taki between 2014-2018. Patients were stratified by non-RRT requirement (non-RRT), RRT-requiring acute kidney injury (AKI-RRT), and RRT-requiring end-stage renal disease (ESRD).

Results: Relative to the Te Manawa Taki population, Māori were over-represented across all strata, especially ESRD (61.8%), followed by AKI-RRT (35.0%), and non-RRT (32.4%) (p<0.001). AKI-RRT, overall, had highest in-ICU mortality (31.2%), followed by ESRD (18.0%), and non-RRT (14.7%) (p<0.001). ESRD, however, had highest 1-year mortality (46.1%), followed by AKI-RRT (43.1%), and non-RRT (24.5%) (p<0.001). We did not identify ethnic inequity in mortality outcomes within any stratum. In-ICU mortality was similar by ethnicity amongst AKI-RRT (30.8% amongst Māori, vs 31.5%, p=1.000), and ESRD (16.4% amongst Māori, vs 20.6%, p=0.826). This trend remained at 1 year.

Conclusion: Increased RRT requirement amongst Māori in our ICU is due to higher representation amongst ESRD. AKI-RRT overall had higher in-ICU mortality than ESRD, but this reversed at 1-year. There was no ethnic inequity in mortality measures across all strata.


Biography:

The presenter is an advanced trainee in nephrology (Royal Australasian College of Physicians) and adult intensive care (College of Intensive Care Medicine) based in New Zealand.

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